Communicating with patients and families about illness progression and end of life A review of studies using direct observation of clinical practice

Funded by

The Health Foundation Logo

8 December 2021

Published journal: BMC Palliative Care



There is growing recognition that a diverse range of health care professionals need competence in palliative approaches to care. Effective communication is a core component of such practice. This article informs evidence-based communication about illness progression and end of life through a rapid review of studies that directly observe how experienced clinicians manage such discussions.


The current rapid review updates findings of a 2014 systematic review, focussing more specifically on evidence related to illness progression and end-of-life conversations. Literature searches were conducted in nine bibliographic databases. Studies using conversation analysis or discourse analysis to examine recordings of actual conversations about illness progression or end of life were eligible for inclusion in the review. An aggregative approach was used to synthesise the findings of included studies.


Following screening, 26 sources were deemed to meet eligibility criteria. Synthesis of study findings identified the structure and functioning of ten communication practices used in discussions about illness progression and end-of-life. Conclusion: The ten practices identified underpin five evidence-based recommendations for communicating with patients or family members about illness progression and end of life


Ekberg. S, Parry. R Land.V & et al (2021), Communicating with patients and families about illness progression and end of life: a review of studies using direct observation of clinical practice, BMC Palliative Care, vol 20, 186.

You might also like...


Webinar: Speeding up NHS service transformation – how can we do better?


In this webinar we were joined by Dr Tim Ferris, NHS England’s Director of Transformation, to...

Watch video

Journal article

A systematic review of nudge interventions to optimize medication prescribing

Journal article

 Interventions to optimize medication prescribing

Press release

Government must be realistic about the time and resources needed to clear the NHS backlog

Press release

Health Foundation response to the publication of the Health and Social Care Select Committee's...

Kjell-bubble-diagramArtboard 101 copy

Get social

Nurses trained outside the UK have long played a vital role in delivering NHS services. This week's data from…

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more